We assess the impact of an anisotropic space and time grid adaptation technique on our ability to solve numerically solute transport in heterogeneous porous media. Heterogeneity is characterized in terms of the spatial distribution of hydraulic conductivity, whose natural logarithm, Y, is treated as a second-order stationary random process. We consider nonreactive transport of dissolved chemicals to be governed by an Advection Dispersion Equation at the continuum scale. The flow field, which provides the advective component of transport, is obtained through the numerical solution of Darcy's law...

Obesity and hypertension are recognized disease states that share many similarities including complex physiology, therapeutic response to both lifestyle modification and pharmacotherapy, and the need for long-term management. Both were initially believed to be disorders of lifestyle rather than true disease entities, and initial efforts at developing medical and surgical therapies were criticized. Ultimately, both have proven to be amenable to treatments that control their underlying physiology. Both hypertension and obesity have complex pathophysiology involving multiple regulatory pathways that may require combination therapies in addition to lifestyle modification to reach therapeutic goals...

The use of hydroponic systems for cultivation in controlled climatic conditions and the selection of suitable genotypes for the specific environment help improving crop growth and yield. We hypothesized that plant performance in hydroponics could be further maximized by exploiting the action of plant growth-promoting organisms (PGPMs). However, the effects of PGPMs on plant physiology have been scarcely investigated in hydroponics. Within a series of experiments aimed to identify the best protocol for hydroponic cultivation of soybean [Glycine max (L...

BACKGROUND: Endoscopic sleeve gastroplasty (ESG) is a technique for managing mild to moderately obese patients. We aimed to evaluate the long-term outcomes, reproducibility, and predictors of weight response in a large multicenter cohort. METHODS: Patients who underwent ESG between January 2013 and December 2015 in three centers were retrospectively analyzed. All procedures were performed using the Apollo OverStitch device (Apollo Endosurgery, Austin, TX). We performed per protocol (PP) and intention-to-treat (ITT) analyses, where patients lost to follow-up were considered failures...

Obesity is a major health crisis resulting in comorbidities such as hypertension, type 2 diabetes, and obstructive sleep apnea. The need for safe and efficacious drugs to help assist with weight loss and reduce cardiometabolic risk factors is great. With several FDA-approved drugs on the market, there is still a great need to develop long-term obesity treatments or noninvasive oral agents to help assist individuals with obesity when used in conjunction with lifestyle modifications.

Weight management medications (WMM) are underutilized as an adjunct to behavioral and lifestyle interventions. In fiscal years 2014-2015, a total of approximately 2500 veterans-a mere 2% of veterans receiving care from the Veterans Health Administration (VHA)-eligible for a WMM received a prescription for one. A State of the Art Conference on Weight Management workgroup, focused on pharmacotherapy, developed evidence-based recommendations and strategies to foster the appropriate use of WMM in the VHA. The workgroup identified patient, prescriber, and health system barriers to and facilitators for prescribing WMM...

The epidemic of obesity continues at alarming rates, with a high burden to our economy and society. The American Gastroenterological Association understands the importance of embracing obesity as a chronic, relapsing disease and supports a multidisciplinary approach to the management of obesity. Because gastrointestinal disorders resulting from obesity are more frequent and often present sooner than type 2 diabetes mellitus and cardiovascular disease, gastroenterologists have an opportunity to address obesity and provide an effective therapy early...

Obesity management requires a multidisciplinary approach, as there are many factors that contribute to the development of obesity, as well as the preservation of excess weight once it has been gained. Diet, exercise, and behavior modification are key components of treatment. In addition to lifestyle changes, weight gain secondary to medications is an important modifiable risk factor. Even after appropriate lifestyle modification, and medication adjustments (where possible) to avoid agents that can contribute to weight gain, many patients are still unable to achieve clinically meaningful weight loss...

Phenomenon. As one of the most common chronic disease affecting adults and children, obesity is a major contributor to noncommunicable diseases, both nationally and globally. Obesity adversely affects every organ system, and as such it is imperative that the United States Medical Licensing Examination (USMLE) adequately assesses students' knowledge about the science and practice of obesity management. The purpose of this study was to evaluate the coverage and distribution of obesity-related items on the three USMLE Step examinations...

BACKGROUND & AIMS: Endoscopic sleeve gastroplasty (ESG) is an incisionless, minimally invasive bariatric procedure that reduces the length and width of the gastric cavity to facilitate weight loss. We performed a prospective study to evaluate the effects of ESG on total body weight loss and obesity-related comorbidities. METHODS: We collected data from 91 consecutive patients (mean age, 43.86 ± 11.26 years; 68% female) undergoing ESG from August 2013 through March 2016...

BACKGROUND: Patients who undergo bariatric surgery often have inadequate weight loss or weight regain. OBJECTIVES: We sought to discern the utility of weight loss pharmacotherapy as an adjunct to bariatric surgery in patients with inadequate weight loss or weight regain. SETTING: Two academic medical centers. METHODS: We completed a retrospective study to identify patients who had undergone bariatric surgery in the form of a Roux-en-Y gastric bypass (RYGB) or a sleeve gastrectomy from 2000-2014...

OBJECTIVES: The AspireAssist System (AspireAssist) is an endoscopic weight loss device that is comprised of an endoscopically placed percutaneous gastrostomy tube and an external device to facilitate drainage of about 30% of the calories consumed in a meal, in conjunction with lifestyle (diet and exercise) counseling. METHODS: In this 52-week clinical trial, 207 participants with a body-mass index (BMI) of 35.0-55.0 kg/m(2) were randomly assigned in a 2:1 ratio to treatment with AspireAssist plus Lifestyle Counseling (n=137; mean BMI was 42...

As the prevalence of obesity continues to increase, the need for effective long-term treatment strategies for the overweight and the obese is critical. Pharmacology fills a large treatment gap between behavioral therapy, which is insufficient for the majority of patients, and devices and surgery, which are available to only a subset of patients. Naltrexone HCl and bupropion HCl Extended-Release (naltrexone XR/bupropion XR) was approved by the Food and Drug Administration for chronic weight management in 2014...

OBJECTIVE: To characterize the adoption of antiobesity pharmacotherapies, as compared with that of the newest antidiabetes pharmacotherapy, subtype 2 sodium-glucose transport protein inhibitors (SGLT2s), among prescribers in the United States. METHODS: A retrospective analysis of 2012 to 2015 data extracted from the IMS Health National Prescription Audit™ and Xponent™ assessed adoption rates of antiobesity pharmacotherapies and SGLT2s. RESULTS: The number of dispensed antidiabetes prescriptions was 15 times the number of dispensed antiobesity prescriptions...

Successful treatment of obesity requires a multidisciplinary approach including diet, exercise and behavioral modification. As lifestyle changes are not sufficient for some patients, pharmacologic therapies should be considered as adjuncts to lifestyle interventions. In this article, we review clinical indications, mechanisms of action, dosing/administration, side effects, drug interactions and contraindications for the six most widely prescribed obesity medications. We also summarize the efficacy data from phase 3 trials which led to drug approval...